斜仰卧位与截石位在输尿管软镜吸引取石术中的比较*

Suctioning flexible ureteroscopic lithotripsy in the oblique supine position and lithotomy position: a comparative study*

摘要:

目的??比较斜仰卧位与截石位在输尿管软镜吸引取石术中应用的安全性及疗效。方法?两组上尿路结石患者共82例，其中斜仰卧位47例，截石位35例，术前两组患者在年龄、性别和合并症等方面比较，差异均无统计学意义（P >0.05），比较两组患者的手术时间、肾盂内压、术后30天清石率、并发症及住院天数。结果?73例手术一期完成，9例留置DJ管2周后成功行软镜手术。与截石位相比，斜仰卧位组患者的结石清除率明显提高，而手术时间明显缩短（P <0.05）。两组的并发症、肾盂内压和住院天数差异无统计学意义（P >0.05）。结论?斜仰卧位输尿管软镜吸引取石术与传统体位相比，同样安全且碎石效率更高。

Abstract:

Objective?To compare the safety and efficacy of oblique supine position and lithotomy position in suctioning flexible ureteroscopic lithotripsy.?Methods?82 patients with upper urinary calculi were divided into two groups. Group 1 included 47 patients who were treated by suctioning flexible ureteroscopy in oblique supine position. Group 2 included 35 patients who were treated in lithotomy position. There was no significant statistical difference in age, gender and complications between the two groups before surgery (P > 0.05). The operative time, stone-free rates at postoperative 30 d, renal pelvic pressure (RPP), postoperative complications (graded by the Clavien system) and length of stay were compared.?Results?Retrograde Intrarenal Surgery (RIRS) was successful in 73 cases, and 9 cases of patients were done successfully after indwelling DJ tube 2 weeks. Compared with lithotomy position, a significantly greater stone-free rate of 30 d, shorter operative time (P < 0.05). There was no difference in complication rate of Clavien grade I and Clavien grade II, RPP and length of stay (P > 0.05).?Conclusions?Suctioning flexible ureteroscopic lithotripsy in the oblique supine position is safe, and more effective than supine lithotomy position.